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Objective:To determine the median effective dose (ED 50) of 0.5% ropivacaine based on femoral nerve cross-sectional area for ultrasound-guided femoral nerve block. Methods:Patients of both sexes, aged 18-64 yr, of American Society of Anesthesiologists physical status I or Ⅱ, with body mass index of 20-30 kg/m 2, scheduled for elective open reduction and internal fixation for patella fracture or removal of patella fracture by internal fixation, were enrolled in this study.Ultrasonic localization of femoral nerve was performed for measurement of the femoral nerve cross-sectional area, and 0.5% ropivacaine was injected based on the area.ED 50 was determined by Dixon′s up-and-down sequential method.The initial dose was 0.22 ml/mm 2, and the difference between the two successive doses was 0.02 ml/mm 2.The effective block was defined as complete loss of pain sensation in the areas of anterior skin of knee joint, skin on the inner side of the calf and dorsal medial skin of the foot and the degree of motor block was in stages 1-3 assessed using Brunnstrom motor function within 30 min after nerve block.Nerve block was considered ineffective if pain occurred in any nerve distribution area mentioned above.The study was terminated if 7 effective and ineffective alternating waves occurred.ED 50 and 95% confidence interval (CI) were calculated using Probit analysis. Results:Twenty-seven patients were enrolled in the study with the femoral nerve cross-sectional area (75±5) mm 2.ED 50 (95%CI) of 0.5% ropivacaine for ultrasound-guided femoral nerve block was 0.106 (0.069-0.125) ml/mm 2. Conclusion:ED 50 of 0.5% ropivacaine based on femoral nerve cross-sectional area for ultrasound-guided femoral nerve block is 0.106 ml/mm 2.
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Objective To investigate the effect of sulfentanyl and tropisetron postoperative analgesia pump on perioperative interleukin 6(IL-6),tumor necrosis factor (TNF-α) and insulin resistance in patients undergoing abdominal general anesthesia.Methods From March 2016 to March 2017,120 patients undergoing elective abdominal surgery in our hospital were selected ,all patients were treated with general anesthesia.The patients were randomly divided into control group and observation group according to the digital table ,with 60 cases in each group.The control group was treated with on -demand delivery analgesia.The observation group was treated with sulfentanyl and tropisetron postoperative analgesia pump for postoperative analgesia.The BCS score,VAS score,Ramsay score at the end of operation and after operation were compared.The TNF-α,ISI,IL-6,insulin levels and blood glucose levels of preoperation and postoperation were compared between the two groups .Results Compared with the control group ,the BCS score and Ramsay score of postoperative 0.5d[(2.78 ±0.57) points,(2.27 ±0.39) points],postoperative 1d [(3.04 ±0.48)points,(2.36 ±0.50) points],postoperative 1.5d[(3.24 ±0.51) points,(2.43 ±0.49) points], postoperative 2d[(3.35 ±0.43) points,(2.51 ±0.42) points] in the observation group increased ( t＝-18.604,-8.65,-8.204,-3.967,t＝-9.634,-4.864,-4.610,-2.604,all P＜0.05),the VAS scores of postopera-tive 0.5d[(2.4 ±1.1) points],postoperative 1 d[(1.8 ±0.8) points],postoperative 1.5d[(1.7 ±0.5) points], postoperative 2d[(1.7 ±0.9)points] in the observation group were lower (t＝2.082,4.834,7.934,3.098,all P＜0.05).Compared with the control group ,the insulin,blood sugar,TNF-α,IL-6 of postoperative 0.5d[(7.26 ± 2.17)mU／L,( 5.63 ±0.58 ) mmol／L, ( 148.96 ±20.31 ) g／L, ( 120.54 ±22.27 ) pg／mL], postoperative 1d [(7.37 ±1.74)mU／L,(5.34 ±0.50)mmol／L,(121.35 ±21.07) μg／L,(116.35 ±21.01) pg／mL],postoperative 1.5d[(6.57 ±2.14)mU／L,(5.11 ±0.50)mmol／L,(114.36 ±23.99)μg／L,(113.14 ±18.05)pg／mL],postoper-ative 2d[(5.87 ±1.84)mU／L,(4.87 ±0.51) mmol／L,(100.02 ±18.13) μg／L,(91.37 ±14.88) pg／mL] in the observation group were lower ( t ＝9.374,11.698,6.455,10.161,t ＝8.557,13.027,9.990,8.541,t ＝6.730, 7.917,7.811,2.326,t＝8.003,7.225,3.839,-7.618,all P＜0.05).Compared with the control group ,the ISI of postoperative 0.5d[(24.77 ±0.26)×1 000],postoperative 1d[(25.03 ±0.21)×1 000], postoperative 1.5d [(29.65 ±0.17)×1 000],postoperative 2d[(34.54 ±0.19)×1 000] in the observation group were increased (t＝-281.912,-442.121,-248.226,-431.857,all P＜0.05).Conclusion The analgesic effect of sulfentanyl and tropisetron postoperative analgesia pump is good ,it can reduce the postoperative stress response and the levels of IL-6 and TNF-α,and reduce the degree of insulin resistance ,and can be widely used in clinical.
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Objective@#To investigate the effect of sulfentanyl and tropisetron postoperative analgesia pump on perioperative interleukin 6(IL-6), tumor necrosis factor (TNF-α) and insulin resistance in patients undergoing abdominal general anesthesia.@*Methods@#From March 2016 to March 2017, 120 patients undergoing elective abdominal surgery in our hospital were selected, all patients were treated with general anesthesia.The patients were randomly divided into control group and observation group according to the digital table, with 60 cases in each group.The control group was treated with on-demand delivery analgesia.The observation group was treated with sulfentanyl and tropisetron postoperative analgesia pump for postoperative analgesia.The BCS score, VAS score, Ramsay score at the end of operation and after operation were compared.The TNF-α, ISI, IL-6, insulin levels and blood glucose levels of preoperation and postoperation were compared between the two groups.@*Results@#Compared with the control group, the BCS score and Ramsay score of postoperative 0.5d[(2.78±0.57)points, (2.27±0.39)points], postoperative 1d[(3.04±0.48)points, (2.36±0.50)points], postoperative 1.5d[(3.24±0.51)points, (2.43±0.49)points], postoperative 2d[(3.35±0.43)points, (2.51±0.42)points] in the observation group increased (t=-18.604, -8.65, -8.204, -3.967, t=-9.634, -4.864, -4.610, -2.604, all P<0.05), the VAS scores of postoperative 0.5d[(2.4±1.1)points], postoperative 1 d[(1.8±0.8)points], postoperative 1.5d[(1.7±0.5)points], postoperative 2d[(1.7±0.9)points] in the observation group were lower (t=2.082, 4.834, 7.934, 3.098, all P<0.05). Compared with the control group, the insulin, blood sugar, TNF-α, IL-6 of postoperative 0.5d[(7.26±2.17)mU/L, (5.63±0.58)mmol/L, (148.96±20.31)g/L, (120.54±22.27)pg/mL], postoperative 1d[(7.37±1.74)mU/L, (5.34±0.50)mmol/L, (121.35±21.07)μg/L, (116.35±21.01)pg/mL], postoperative 1.5d[(6.57±2.14)mU/L, (5.11±0.50)mmol/L, (114.36±23.99)μg/L, (113.14±18.05)pg/mL], postoperative 2d[(5.87±1.84)mU/L, (4.87±0.51)mmol/L, (100.02±18.13)μg/L, (91.37±14.88)pg/mL] in the observation group were lower (t=9.374, 11.698, 6.455, 10.161, t=8.557, 13.027, 9.990, 8.541, t=6.730, 7.917, 7.811, 2.326, t=8.003, 7.225, 3.839, -7.618, all P<0.05). Compared with the control group, the ISI of postoperative 0.5d[(24.77±0.26)×1 000], postoperative 1d[(25.03±0.21)×1 000], postoperative 1.5d[(29.65±0.17)×1 000], postoperative 2d[(34.54±0.19)×1 000] in the observation group were increased (t=-281.912, -442.121, -248.226, -431.857, all P<0.05).@*Conclusion@#The analgesic effect of sulfentanyl and tropisetron postoperative analgesia pump is good, it can reduce the postoperative stress response and the levels of IL-6 and TNF-α, and reduce the degree of insulin resistance, and can be widely used in clinical.
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Objective To evaluate the effect of propofol on high-mobility group box 1 protein (HMGB1)/Toll-like receptor 4 (TLR4) signaling pathway during hepatic ischemia-reperfusion (I/R) injury in rats.Methods Thirty-six clean-grade healthy male Sprague-Dawley rats,aged 3 months,weighing 250 -300 g,were divided into 3 groups (n=12 each) using a random number table method:sham operation group (group S),hepatic I/R group (group I/R) and propofol group (group P).Hepatic I/R injury was induced by occluding the portal vein and hepatic artery supplying the left and middle lobes of the liver for 1 h followed by 6-h reperfusion in anesthetized rats.Propofol was infused via the tail vein at a rate of 12 mg ·kg-1 · h-1 starting from 20 min before ischemia until 6 h of reperfusion in group P.The rats were sacrificed at 6 h of reperfusion,and the left lobe of the liver was removed for microscopic examination of the pathological changes which were scored and for determination of the expression of HMGB1,TLR4,tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-6) in liver tissues (by Western blot).Results Compared with group S,pathological scores of liver tissues were significantly increased,and the expression of HMGB1,TLR4,TNF-α and IL-6 was up-regulated in I/R and P groups (P＜0.05).Compared with group I/R,pathological scores of liver tissues were significantly decreased,and the expression of HMGB1,TLR4,TNF-α and IL-6 was down-regulated in group P (P＜ 0.05).Conclusion The mechanism by which propofol reduces liver I/R injury is associated with blocking HMGB-1/TLR4 signaling pathway and inhibiting inflammatory responses in rats.
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Objective To evaluate the effect of sevoflurane postconditioning on autophagy during focal cerebral ischemia-reperfusion (I/R) in rats.Methods Forty-five clean-grade healthy male SpragueDawley rats,weighing 280-350 g,were divided into 3 groups (n=15 each) using a random number table method:sham operation group (S group),cerebral I/R group (I/R group) and sevoflurane postconditioning group (SP group).Focal cerebral I/R injury model was established by Zea-Longa method in chloral hydrate-anesthetized rats.The animals in SP group inhaled 2.4％ sevoflurane for 30 min starting from onset of reperfusion.The expression of autophagy-related proteins LC3 and beclin-1 was detected by Western blot at 2 h of reperfusion.The cerebral cortex was removed for examination of the morphology and number of autophagosomes with an electron microscope.Neurological deficit was assessed and scored at 24 h of reperfusion.Rats were sacrificed at 72 h of reperfusion for determination of the cerebral infarct size.Results Compared with S group,the neurological deficit score was significantly increased,the percentage of cerebral infarct size was increased,LC3Ⅱ/LC3Ⅰ ratio in cerebral cortex was increased,the expression of beclin-1 was up-regulated,and the number of autophagosomes was increased in I/R and SP groups (P＜0.05).Compared with I/R group,the neurological deficit score was significantly decreased,the percentage of cerebral infarct size was decreased,LC3Ⅱ/LC3Ⅰ ratio in cerebral cortex was decreased,the expression of beclin-1 was down-regulated,and the number of autophagosomes was reduced in SP group (P＜0.05).Conclusion Sevoflurane postconditioning mitigates focal cerebral I/R injury through inhibiting autophagy in rats.
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Objective To investigate the sleep quality of older adults in Shaoxing City and to examine its influencing factors. Methods Based on a cross-sectional questionnaire survey, a cluster sampling method was adopted to collect participants. Five villages were chosen randomly from 20 in the Yuecheng district of Shaoxing. The respondents were adults aged more than 60 years in the 5 villages. In total,1 303 adults participated,including 603 men and 700 women,and the average age was(70.99±7.38). The information related to sociodemographic factors,health status,sleep characteristics,and behavioral and lifestyle factors were collected.A chi-square test and variance analysis were used to compare sleep quality and sleep duration among participants. An ordinal regression model was adopted to examine the factors influencing sleep quality. Results One hundred and ninety-six (15.0%) older adults reported that sleep quality was always bad during the past year, 180(13.8%)reported that sleep quality was bad occasionally, and 927(71.1%)reported that sleep quality was good every day.The average sleep duration of participants was(6.64±1.38)h per night,and sleep durations for older adults who reported that sleep quality was always bad, bad occasionally, and good every day were (4.21 ± 1.13) h, (6.12 ± 1.40) h, and (7.26 ± 1.39) h, respectively,and older adults with poor sleeping quality had a shorter sleep duration(F=421.828,P<0.001). Being a woman, more than 80 years old, not working, and taking sleeping pills were risk factors for poor sleep quality with ORs (95% CI) of 1.492 (1.132-1.964), 1.564 (1.108-2.206), 1.331 (1.015-1.747), and 14.614(7.164-29.844),respectively.Conclusions Elderly individuals in Shaoxing had poor sleep quality. The sleep quality of those who were women, were oldest and took sleeping pills is cause for concern. Encouraging them to engage in work may improve their sleeping status.
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BACKGROUND:Mesenchymal stem cels have the capacity of self-renewal and differentiation into certain lineage cels under appropriate conditions. But many mechanisms are unknown until now. OBJECTIVE:To clarify the role of miR-302 in the regulation of osteogenic and adipogenic differentiation of adipose-derived mesenchymal stem cels. METHODS:Chemicaly synthesized miR-302 specific mimics were transfected into adipose-derived mesenchymal stem cels as experimental group. miR-NC, miR-302b negative control mimics, was transfected into another cels as control group. By the experiments of alkaline phosphatase staining, alkaline phosphatase activity assay, alizarin red staining, oil red O staining and extraction test, the effect of miR-302 upregulation on the adipogenic and osteogenic differentiation of adipose-derived mesenchymal stem cels was analyzed and compared. Western blot assay was used to detect the expression of Runx2 and alkaline phosphatase after regulation of miR-302. RESULTS AND CONCLUSION: (1) Overexpression of miR-302 decreased the precipitate and activity of alkaline phosphatase significantly as compared with the control group (P < 0.05). (2) Overexpression of miR-302 inhibited the formation of mineral deposits and calcium nodules, and the number of calcium nodules in the experimental group was significantly lower than that in the control group (P < 0.05). (3) The number of cels positive for oil red O staining was significantly higher in the experimental group than the control group, which further showed the absorbance values of oil red O staining in the experimental group obtained in the extraction test were significantly increased (P < 0.05). (4) At 6 days of osteogenic induction, the expressions of Runx2 and alkaline phosphatase in the experimental group were decreased to different extents. These findings indicate that overexpression of miR-302 can suppress osteogenesis and accelerate adipocytes generation of adipose-derived mesenchymal stem cels. miR-302 plays a two-way regulatory role to balance the osteogenic and adipogenic differentiation of mesenchymal stem cels.
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Objective To investigate the effects of edaranvone on lung injury induced by myocardial ischemia-reperfusion (I/R) in rats. Methods Twenty-four male Wistar rats weighing 250-300 g were randomly assigned to one of 4 groups ( n = 6 each): group Ⅰ sham operation (group S); group Ⅱ myocardial I/R and group Ⅲ and Ⅳ different doses of edaravone ( group E1, E2 ). The animals were anesthetized, intubated and mechanically ventilated. In group Ⅱ-Ⅳ myocardial I/R was induced by occlusion of left anterior descending coronary artery for 45 min followed by 3 h reperfusion. In group Ⅲ and Ⅳ edavarone 3 and 10 mg/kg was administered via right femoral vein at 1 min before reperfusion respectively. The animals were sacrificed by exsanguination at the end of 3 h reperfusion. Blood was collected for determination of serum CK-MB activity and total protein content. The left lung was lavaged and the broncho-alveolar lavage fluid (BALF) was colleted for determination of protein content. Pulmonary permeability index (PPI) was calculated. The lung tissue was obtained for determination of BD-2 mRNA and protein and TNF-α expression. Results The serum CK-MB activity, PPI,BD-2 mRNA and protein and TNF-α expression were significantly higher in group I/R, E1 and E2 than in group S,but significantly lower in group E1 and E2 than in group I/R and in group E2 than in group E1. Conclusion Edaravone can reduce myocardial I/R-induced lung injury by scavenging oxygen free radicals and inhibiting inflammatory response of lung tissues in rats.